Lavaca Family Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LAVACA FAMILY CLINIC

Practice address

1000 W Main St
Lavaca, AR 72941-3530

Phone

(479) 674-9181

NPI assigned

Feb 18, 2008

Organization subpart

Yes

Parent organization

BOONVILLE COMMUNITY HOSPITAL INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dzaidi Daud

Title

Ceo

Phone

(479) 675-2800

Specialties & licenses 1

Addresses

Part of

Booneville Community Ho

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1407024045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W MAIN ST",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729413530",
            "telephone_number": "479-674-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVACA FAMILY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOONVILLE COMMUNITY HOSPITAL INC",
        "enumeration_date": "2008-02-18",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "DAUD",
        "authorized_official_first_name": "DZAIDI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-675-2800"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lavaca, AR
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.